GLEN T CLARK (MD) – Emergency Medicine Physician, NPI 1932110657
Emergency Medicine Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
3,158 EMERGENCY MEDICINE in MI
Provider Addresses for GLEN T CLARK (MD)
36555 26 Mile Rd Ste 1100
Lenox, MI 480483186
Phone: (947) 523-4040
Type: Location
26901 BEAUMONT BLVD STE 3D
SOUTHFIELD, MI 480333849
Phone:
Type: Mailing
130, Town Center Drive, Troy, Oakland County, Michigan, 48084, United States
203
TROY, MI 480841744
Phone:
Fax: (248) 585-8266
Type: Mailing
Beaumont Hospital, Grosse Pointe, 468, Cadieux Road, Grosse Pointe, Wayne County, Michigan, 48230, United States
GROSSE POINTE, MI 482301507
Phone: (313) 473-1000
Fax: (313) 473-1934
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2008-07-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080716000515 | I | Emergency Medicine | MI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 355 | 313 | $0 |
| 99285 | Emergency department visit with high level of medical decision making | 220 | 210 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 112 | 107 | $0 |
| 99291 | Critical care, first 30-74 minutes | 56 | 56 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 11 | 11 | $0 |
Insurance plans in this area (ZIP 48048)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MI | |
| Interventional Radiology, Diagnostic Radiology | MI | |
| - | MI | |
| - | MI | |
| Family Practice | MI | |
| - | MI | |
| P A T H O L O G Y | MI | |
| - | MI | |
| Emergency Medicine | CA | |
| - | MI |
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